Fax form to (513) 345-3053 or mail to

	Lieutenant Dennis Meyer
	Cincinnati Police Division
	3295 Erie Avenue
	Cincinnati, OH 45208

MAKE ALL CHECKS PAYABLE TO: GREATER CINCINNATI SPORTS CORPORATION

I ACKNOWLEDGE THAT BY SIGNING THIS DOCUMENT, I AM RELEASING US CYCLING, INC., 
THE CINCINNATI POLICE DIVISION, THE LOVELAND POLICE DEPT., CYCLE CINCINNATI LOVELAND INC., 
GREATER CINCINNATI SPORTS CORPORATION FROM LIABILITY.  THIS ENTRY IS A CONTRACT WITH LEGAL 
CONSEQUENCES. I HAVE BEEN ADVISED TO READ IT CAREFULLY BEFORE SIGNING. I ACKNOWLEDGE 
THAT CYCLING IS AN INHERENTLY DANGEROUS SPORT AND FULLY REALIZE THE DANGERS OF 
PARTICIPATING IN A BICYCLE RACE AND FULLY ASSUME THE RISKS ASSOCIATED WITH SUCH 
PARTICIPATION INCLUDING, BY WAY OF EXAMPLE AND NOT LIMITATION, THE FOLLOWING: THE 
DANGERS OF COLLISION WITH PEDESTRIANS, VEHICLES AND OTHER RACERS AND FIXED OR MOVING 
OBJECTS, THE RELEASEEÕS OWN NEGLIGENCE, AND WEATHER CONDITIONS; AND THE POSSIBILITY 
OF SERIOUS PHYSICAL AND/OR MENTAL TRAUMA OR INJURY ASSOCIATED WITH ATHLETIC CYCLING 
COMPETITION. 

FOR MYSELF, MY HEIRS, EXECUTORS, ADMINISTRATORS, LEGAL REPRESENTATIVES, ASSIGNEES AND 
SUCCESSORS IN INTEREST, I HEREBY WAIVE, RELEASE HOLD HARMLESS AND NOT TO SUE THE RELEASEES 
AND THE SPONSORS OF THE EVENT, THE ORGANIZER, ANY PROMOTING ORGANIZATIONS, PROPERTY 
OWNERS, LAW ENFORCEMENT AGENCIES, ALL PUBLIC ENTITIES, FROM ANY AND ALL RIGHTS AND 
CLAIMS INCLUDING CLAIMS ARISING FROM THE RELEASEES OWN NEGLIGENCE, WHICH I HAVE OR 
WHICH MAY HEREAFTER ACCRUE TO ME AND FROM ANY AND ALL DAMAGES WHICH MAY BE SUSTAINED 
BY ME DIRECTLY OR INDIRECTLY IN CONNECTION WITH, OR ARISING OUT OF, MY PARTICIPATION 
WITH THE EVENT, OR TRAVEL TO OR RETURN FROM THE EVENT.

I AGREE IT IS MY SOLE RESPONSIBILITY AND UNDERSTAND ANY SPECIAL REGULATIONS FOR THE 
EVENT.  I ACCEPT RESPONSIBILITY FOR THE RACE AND MUST WEAR A HELMET TO COMPETE. EVERY 
TERM AND PROVISION OF THIS AGREEMENT IS INTENDED TO BE SEVERABLE. IF ANY ONE OR MORE OF 
THEM IS FOUND TO BE UNENFORCEABLE OR INVALID, THAT SHALL NOT AFFECT THE OTHER TERMS AND 
PROVISIONS, WHICH SHALL REMAIN BINDING AND ENFORCEABLE.